Cannabis & Medication Interactions

CBD comes from the cannabis sativa plant and is legal to buy, sell and possess in the U.K but it must only be classed as a food supplement to be legal for sale. CBD products can only be sold as a medicinal product with the appropriate licence. It is available to buy both online and in food and health shops in a variety of strengths and profiles and is becoming a popular choice of health supplement in the U.K, with the number of people who use CBD products doubling to almost 250,000 in just a year with people treating a range of ailments and conditions.

In trials, studies and from peoples own experiences, THC has also been proven to have medicinal benefits and healing properties but it is an illegal class B controlled drug in the U.K with possession of the drug potentially landing you with up to 5 years in prison, an unlimited fine or both. People in the U.K are being forced to move to other countries so they can receive cannabis treatment without fear of criminal action being taken against them and until the laws on cannabis change this desperation among people is only going to continue.

Although research and studies have been carried out there’s still a lot to learn about cannabis and its components but the cannabinoids of most therapeutic interest among researchers are CBD and THC. If you are new to cannabis products it would be wise to check that it will not interact with any medication that you are currently taking so that you don’t get any unwanted side affects or worsen your situation. Studies so far have shown that serious adverse affects from cannabis are rare but they did show that CBD and THC may interact with certain types of drugs.


CBD and THC are metabolised by the CYP3A4 enzyme mainly found in the liver and intestines and the CYP2C9 enzyme, its major role is in the oxidation of both xenobiotic and endogenous compounds.

CYP3A4 inhibitors slightly increase THC levels.

Common CYP3A4 inhibitor medications include, but are not limited to; cimetidine, amiodarone, erythromycin, fluconazole, miconazole, diltiazem, verapamil, delavirdine, amprenavir, fosamprenavir, conivaptan, clarithromycin, telithromycin, nefazodone, itraconazole, ketoconazole, atazanavir, darunavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir.

CYP3A4 inducers slightly decrease THC and CBD levels.

Common CYP3A4 inducer medications include, but are not limited to; amprenavir, barbituates, carbamazepine, clotrimazole, dexamethasone, efavirenz, ethosuximide, griseofulvin, modafinil, nevirapine, oxcarbazepine, phenobarbital, phenytoin,  prednisone, primidone, rifabutin, rifampin, rifapentine, ritonavir, topiramate.

THC is a CYP1A2 inducer and can decrease serum concentrations of clozapine, duloxetine, naproxen, cyclobenzaprine, olanzapine, haloperidol, and chlorpromazine.

CBD is a potent inhibitor of CYP3A4 and CYP2D6 and may increase serum concentrations of macrolides, calcium channel blockers, benzodiazepines, cyclosporine, sildenafil (and other PDE5 inhibitors), anti-histamines, haloperidol, anti-retrovirals, SSRIs, tricyclic antidepressants, anti-psychotics, beta blockers, opioids and some statins.

CBD and THC also increase warfarin levels and CBD increased clobazam levels in children treated with CBD for epilepsy.

It is important to note that not all drugs within a certain class of medication are the same and the effects and interactions between each drug will be different. If you’re not sure about how THC or CBD may interact with your medication you should always consult a medical professional for further advice.

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